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Case 1.5
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
You mentioned your estimation of the approximate surface area being 4–5%. How would you assess the surface area of burns in general?In patients with small burns, I use the template of the patient’s palm and fingers for small, patchy burns, where the surface of the patients’ hands with fingers adducted has been taken to represent approximately 1% of their TBSA, orIn those with larger and patchy burns, I use tools that provide a graphical record of the extent of the burn, such as:the Lund and Browder charts in children, orthe Wallace rule of nines in adults.In addition, I am aware of the development of specific apps to assist with this assessment.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
For this particular patient, I would employ the Lund and Browder classification, which allows accurate burn estimation based on the premise that the patient’s palm is of average size. The palm represents approximately 1% of the total body surface area. An alternative system is the Wallace rule of nines by which anatomical segments are given in estimated burn percentages. In accordance with this system, the head and neck represent 9%, and the anterior and posterior thorax region are 18% each. Each lower limb is 18%, while each upper limb is 9%. This system also represents scattered or irregular areas as 1% of the patient’s palm.
Burns
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
The Wallace Rule of Nines is the traditional method of assessing burns in adults (Figure 19.1) (5). The arms account for 9% each, each leg 18%, the head and neck 9%, the abdomen and thorax 18% front and 18% back, and the remaining 1% is the genitalia and perineum. Due to the changing proportions of a child’s head and limb size relative to the total body surface area, the standard Rule of Nines should not be used in children.
Association between pain drawing and psychological factors in musculoskeletal chronic pain: A systematic review
Published in Physiotherapy Theory and Practice, 2019
Felipe Reis, Fernanda Guimarães, Leandro Calazans Nogueira, Ney Meziat-Filho, Tiago A. Sanchez, Timothy Wideman
The relationship between structural damage and the experience of pain has been criticized, especially in chronic pain conditions. It has also been postulated that an expanded distribution of pain could be linked to psychological factors. To obtain a graphic representation of pain location and distribution in people with pain, the pain drawing (PD) is used by asking them to draw where they feel pain on a body chart. There are some methods described in the literature to score the pain area and include: a grid system (i.e. Margolis method) (Margolis, Tait, and Krause, 1986); percentage of total body area affected by pain (i.e. Wallace rule of nines) (Masterton and Burns, 1986); classification into “organic” or “nonorganic” (i.e. Ransford penalty points, Sivik penalty points, and Udén method) (Ransford, Cairns, and Mooney, 1976; Sivik, Gustavsson, and Klingberg Olsson, 1992; Udén, Åström, and Bergenudd, 1998); and more recently, computerized assessment (Barbero et al, 2015; Persson, Garametsos, and Pedersen, 2011; Reis et al, 2014).